| Name: | Lakeshore Pediatrics of Russellville, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 01 Oct 2007 (17 years ago) (Companies founded in October 2007) |
| Entity Number: | 000-254-545 |
| Register Number: | 000254545 |
| ZIP code: | 35653 (Companies in Franklin, 35653) |
| County: | Franklin |
| Place of Formation: | Franklin County |
| Principal Address: | RUSSELLVILLE, AL |
| Registered Office Street Address: | 603 GANDY ST NERUSSELLVILLE, AL 35653 |
| Authorized Capital: | 1,000 NPV |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1326352873 | 2010-07-27 | 2010-07-27 | 603 GANDY ST NE, RUSSELLVILLE, AL, 356531911, US | 603 GANDY ST NE, RUSSELLVILLE, AL, 356531911, US | |||||||||||||||||
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| Phone | +1 256-331-5055 |
| Fax | 2564604647 |
Authorized person
| Name | REBECCA THOMPSON |
| Role | DIRECTOR |
| Phone | 2563315055 |
Taxonomy
| Taxonomy Code | 261QR1300X - Rural Health Clinic/Center |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| RIVAS, AUGUSTIN G | Agent |
| Name | Role |
|---|---|
| RIVAS, AUGUSTIN G | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
